Haematologica, Vol 94, Issue 11, 1599-1602 doi:10.3324/haematol.2009.009100
Copyright © 2009 by Ferrata Storti Foundation
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Multiple Myeloma

Multiparameter flow cytometry quantification of bone marrow plasma cells at diagnosis provides more prognostic information than morphological assessment in myeloma patients

Bruno Paiva, Maria-Belén Vidriales, Jose J. Pérez, Gema Mateo, Maria Angeles Montalbán, Maria Victoria Mateos, Joan Bladé, Juan José Lahuerta, Alberto Orfao, Jesús F. San Miguel

On behalf of the GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) cooperative study groups

Correspondence: Jesús F. San-Miguel, Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain. E-mail:sanmigiz{at}usal.es

Quantification of bone marrow plasma cells in multiple myeloma patients using conventional morphology is of limited prognostic value, while the merit of multiparameter flow cytometry immunophenotyping is still considered unproven. Here we compare the bone marrow plasma cell counts obtained by morphology and multiparameter flow cytometry and explore the potential prognostic impact of both techniques in 765 newly diagnosed, uniformly treated multiple myeloma patients. Although multiparameter flow cytometry generally yields lower plasma cell counts (median percentage of 11% vs. 40%, respectively; p<0.001), there is a significant positive correlation between the two techniques (R =0.46, p<0.001). Regarding prognosis, multivariate analysis selected the bone marrow plasma cell counts obtained by multiparameter flow cytometry as an independent prognostic factor for overall survival (p=0.007), supporting the incorporation of multiparameter flow cytometry immunophenotyping into the routine diagnostic evaluation of multiple myeloma patients and validating the clinical utility of bone marrow plasma cell counting by multiparameter flow cytometry approaches. (clinicaltrials.gov identifier: NCT00560053).

Key words: multiple myeloma, immunophenotyping, conventional morphology, multiparameter flow cytometry quantification.




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